Arthroscopic Reverse Bankart Surgical Repair

2021 ◽  
Vol 1 (5) ◽  
pp. 263502542110348
Author(s):  
Robert S. Dean ◽  
Anirudh K. Gowd ◽  
Carson D. Bunker ◽  
Edward C. Becker ◽  
Eric J. Dennis ◽  
...  
Keyword(s):  
Lifestyle Modification ◽  
Return To Sport ◽  
Rehabilitation Program ◽  
Labral Repair ◽  
Suture Anchors ◽  
Shoulder Dysfunction ◽  
Nonsurgical Management ◽  
Labral Tears ◽  
Diagnostic Arthroscopy ◽  
Lateral Decubitus

Background: Posterior glenoid labrum lesions occur in only 2% to 10% of all cases of shoulder instability, yet these injuries may cause significant shoulder dysfunction in an athletic population. Moreover, these injuries frequently require surgical intervention and present a unique surgical challenge. Indications: Indications for arthroscopic posterior labral repair include symptomatic posterior labral tears identified on magnetic resonance imaging with or without contrast, that failed nonsurgical management (ie, lifestyle modification, nonsteroidal anti-inflammatory drug, and physical therapy). Patients may present with a positive posterior load and shift or positive posterior apprehension test. Technique Description: With the patient in the lateral decubitus position, use a standard posterior superior portal, an ancillary anterior superior portal, a posterior-inferior, and the portal of Wilmington. After portal placement and diagnostic arthroscopy, the torn labrum is debrided. The torn portion of the posterior labrum is then mobilized from approximately the 6 o’clock to 10 o’clock positions, and a curette and shaver are used to produce a bleeding margin for fixation. Two double-loaded 2.4-mm suture anchors are placed, passed, and tied; one at the 6:30 o’clock position and the other at the 8 o’clock position. A cinch stich configuration using a 2.9-mm pushlock anchor can be used at the 10 o’clock position. A polydioxanone suture is used to assist with capsular plication and to close the posterior portal. Results: The literature suggests that 90% to 94% of patients are able to return to their desired sport with 5% to 10% reporting recurrent instability by 2 years after operation. Two out of 3 patients report no limitations at 2 years. Discussion/Conclusion: Arthroscopic repair of posterior labral tears with suture anchors can be an effective surgical option for patients with reverse Bankart lesions. Using advanced imaging to identify concomitant pathologies, meticulous surgical technique, direct visualization of the anatomy and anchor placement, and a dedicated rehabilitation program, greater than 90% of patients can expect to return to sport.

Acetabular Labral Tear Dimensions and Number of Suture Anchors Used to Repair in Patients with Femoroacetabular Impingement Syndrome

2021 ◽  
Author(s):  
Guillaume D. Dumont ◽  
Matthew J. Pacana ◽  
Adam J. Money ◽  
Thomas J. Ergen ◽  
Allen J. Barnes ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Impingement Syndrome ◽  
Labral Tear ◽  
Labral Repair ◽  
Suture Anchors ◽  
Labral Tears ◽  
Femoroacetabular Impingement Syndrome ◽  
The Mean ◽  
Tear Size ◽  
Anterior Extent

AbstractFemoroacetabular impingement syndrome (FAIS) is commonly associated with acetabular labral tears. Correction of impingement morphology and suture anchor repair of labral tears have demonstrated successful early and midterm patient-reported outcomes. The purpose of this study was to evaluate the posterior and anterior extent and size of labral tears in patients with FAIS undergoing arthroscopic labral repair, and to evaluate the number of suture anchors required to repair these tears. The design of this study was retrospective case series (Level 4). A single surgeon's operative database was retrospectively reviewed to identify patients undergoing primary arthroscopic hip labral repair between November 2014 and September 2019. Patient-specific factors and radiographic measurements were recorded. Arthroscopic findings including labral tear posterior and anterior extents, and the number of suture anchors utilized for the repair were recorded. Linear regression was performed to identify factors associated with labral tear size. The number of suture anchors used relative to labral tear size was calculated. Three-hundred and thirteen patients were included in the study. The mean posterior and anterior extent for labral tears were 11:22 ± 52 and 2:20 ± 34 minutes, respectively. Mean tear size was 2 hours, 58 minutes ± 45 minutes. The mean number of suture anchors utilized for labral repair was 3.1 ± 0.7. The mean number of anchors per hour of labral tear was 1.1 ± 0.3. Increased age, lateral center edge angle, and α angle were associated with larger labral tears. Our study found that acetabular labral tears associated with FAIS are, on average, 3 hours in size and centered in the anterosuperior quadrant of the acetabulum. Arthroscopic labral repair required 1.1 anchors per hour of tear size, resulting in a mean of 3.1 anchors per repair. Level of Evidence IV

scholarly journals Acetabular Subchondral and Cortical Breach During Labral Repair with Suture Anchors: Influence of Portal Location, Curved vs Straight Drill Guides, and Drill Starting Point

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0037
Author(s):  
Guillaume D. Dumont ◽  
Adam Money ◽  
Zachary Thier
Keyword(s):  
Subchondral Bone ◽  
Articular Surface ◽  
Labral Repair ◽  
Relative Impact ◽  
Suture Anchors ◽  
Drill Guide ◽  
Labral Tears ◽  
Starting Point ◽  
Drill Holes ◽  
Acetabular Rim

Objectives: Acetabular labral tears are commonly treated with arthroscopic repair using suture anchors. Iatrogenic chondral injury has been cited as one of the more common complications during hip arthroscopy, and can occur while pre-drilling for suture anchors. Proposed factors contributing to penetration of the articular subchondral bone or the far cortex of the acetabulum include the portal utilized for drilling; the position of the drill guide relative to the acetabular rim (on rim, ON; off rim, OFF); and the use of straight (ST) versus curved (CU) drill guides. The purpose of this study was to evaluate the relative impact of these variables on drill penetration of the acetabular subchondral bone or the far cortex of the acetabulum. Methods: Sixty sawbone acetabula models were marked at the 3, 2, 1, 12, and 11 o’clock position. A Simulated anterior (AP), anterolateral (AL), and distal anterolateral accessory (DALA) portals were created. Twelve groups of five acetabula were drilled at each clock face position: ST/AP/ON; ST/AL/ON; CU/AP/ON; CU/AL/ON; ST/AP/OFF; ST/AL/OFF; CU/AP/OFF; CU/AL/OFF; ST/DALA/ON; ST/DALA/OFF; CU/DALA/ON; CU DALA/OFF. Perforations of the articular subchondral bone and far cortex of the acetabulum were recorded. Results were tabulated and analyzed to assess the relative impact of each variable both in aggregate and at each position on the clock face. Results: A total of 300 acetabular suture anchor drill holes were created on 60 acetabula 12 combinations of portal utilized (anterior, anterolateral, distal anterolateral accessory), drill guide type (curved or straight), and rim position (on rim, off rim). A total of 38/300(12.7%) drillings perforated the subchondral bone, and 45/300(15%) breach the far cortex. Drilling from the AP, AL, and DALA portal breached the articular subchondral bone 21/100 (21%), 17/100(17%), and 0/100(0%) respectively; and breached the far acetabular cortex 36/100(36%), 1/100(1%), and 8/100(8%) respectively. Drillings using a curved drill guide penetrated the subchondral bone on 14/150(9.3%) attempts and drillings using a straight drill guide penetrated the subchondral bone 33/150(22%) attempts (p=0.0025). Drillings with an “On Rim” start point breached the articular subchondral bone 29/150(19.3%) versus 9/150(6%) for drillings with an “Off Rim” start point; and breached the far acetabular cortex 21/150(14%) times versus 24/150(16%) times. Articular surface penetrations were most frequent at the 2 and 3 o’clock positons, and far cortex perforations were most frequent at the 11 and 12 o’clock positions. Conclusion: This study quantifies the relative impact of portal location, drill guide, and starting point on the acetabular rim on acetabular subchondral bone and far cortex penetration. Portal location had the highest impact, with the DALA portal noted to be the safest. Curved drill guides also reduced the number of acetabular subchondral bone penetrations. These findings can be used to influence arthroscopic technique during acetabular labral repair.

scholarly journals Evaluation of Repair of the Hip Labrum under Simulated Full Weight-Bearing

2017 ◽  
Vol 27 (1) ◽  
pp. 104-109 ◽  
Author(s):  
Jason L. Koh ◽  
Kavish Gupta
Keyword(s):  
Soft Tissues ◽  
Suture Anchor ◽  
Weight Bearing ◽  
Labral Repair ◽  
Full Weight Bearing ◽  
Suture Anchors ◽  
Gap Formation ◽  
Labral Tears ◽  
Axial Cyclic Loading ◽  
Load To Failure

Introduction Repairs of labral tears are performed for unstable tears, hip instability, and after detachment concomitant to the treatment of femoroacetabular impingement (FAI), but limited data is known about the strength of repair. This study evaluated the effect of simulated axial weight-bearing on suture anchor based repair of the acetabular labrum. Methods 3 cadaveric pelvises underwent creation of a 1.5 cm anterior-superior labral tear in each hip. The tears were then repaired using 2 suture anchors per hip. Following repair, the hip joint underwent axial cyclic loading to 756 N, and were inspected for separation of the labrum from the acetabulum. The strength of the suture anchor repair was evaluated by testing load to failure, in-line with insertion. Results Upon visual examination, all 6 repairs remained fully intact following loading with no visible gap formation or damage at the repair site. In all cases an arthroscopic probe could not be inserted under the edge of the repair. The mean failure force of the 12 suture anchors, in-line with insertion, was 154 N ± 44 N. Conclusions Acetabular labral suture anchor repairs may be able to immediately withstand the physiological loads of axial weight-bearing. Labral repair may be able to tolerate axial weight-bearing immediately after repair, preserving the strength and integrity of muscles and soft tissues.

Posterior Labral Repairs of the Shoulder Among Baseball Players: Results and Outcomes With Minimum 2-Year Follow-up

2019 ◽  
Vol 47 (7) ◽  
pp. 1687-1693 ◽  
Author(s):  
James S. Kercher ◽  
Robert P. Runner ◽  
Timothy P. McCarthy ◽  
Xavier A. Duralde
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Return To Sport ◽  
Chief Complaint ◽  
Postoperative Outcomes ◽  
Labral Repair ◽  
Baseball Players ◽  
Labral Tears ◽  
Previous Level

Background: There is a paucity of information regarding the treatment of posterior labral tears of the shoulder for baseball players. Reports regarding treatment and postoperative outcomes are more limited than its anterior and superior counterparts. Purpose: To evaluate the clinical presentation, surgical findings, postoperative outcomes, and rate of return to sport after arthroscopic repair of posterior labral injuries of the shoulder among baseball players. Study Design: Case series; Level of evidence, 4. Methods: Retrospective review was performed of baseball players who underwent arthroscopic posterior labral repair between 2009 and 2015 by a single surgeon, with a minimum 2-year follow-up. The group was composed of 32 male patients involved in recreational (6.3%), high school (43.8%), college (31.3%), and professional (18.8%) baseball, with a mean age of 20.5 years. Patients were categorized by chief complaint, clinical findings, surgical findings, and concomitant procedures performed. Pre- and postoperative measures included pain scale, range of motion, American Shoulder and Elbow Surgeons shoulder score, return to play, and patient satisfaction. Results: A variety of tear patterns were identified; 32% involved 90° of the posterior superior labrum; 35% involved the posterior 180°; and 32% involved 90° of the posterior inferior labrum. The dominant mechanism of injury was throwing (34.4%). The most common chief complaint was pain (n = 25, 78%), followed by pain and instability symptoms (n = 6, 18.8%), with only 3% citing isolated sensation of instability. Magnetic resonance imaging clearly identified tear patterns in 75% of cases. American Shoulder and Elbow Surgeons scores significantly improved ( P < .0001), increasing on average 30.9 points from the preoperative mean of 65.4 to a postoperative mean of 96.3. No significant range of motion deficits were noted. Tear size and number of anchors utilized did not influence outcomes. Ninety-four percent of athletes returned to play, 61% at previous levels, and 6% did not return. Pitchers had a lower return to previous level of play than position players (41% vs 86%, P = .0113). Conclusion: Arthroscopic treatment of posterior labral tears of baseball players was effective in improving pain and function, resulting in 94% patient satisfaction and 94% return to sport, with 61% returning to previous level of play. Patient presentation is variable, with a majority of patients citing pain rather than instability.

Return to Sports and Minimum 2-Year Outcomes of Primary Arthroscopic Hip Labral Reconstruction for Irreparable Tears in High-Level Athletes With a Propensity-Matched Benchmarking Against a Labral Repair Control Group

2021 ◽  
pp. 036354652110325
Author(s):  
Andrew E. Jimenez ◽  
Peter F. Monahan ◽  
Jade S. Owens ◽  
David R. Maldonado ◽  
Benjamin R. Saks ◽  
...  
Keyword(s):  
Return To Sport ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Control Group ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Labral Tears ◽  
Patient Reported ◽  
High Level

Background: Labral reconstruction has shown promise for the treatment of irreparable labral tears in high-level athletes. The literature is scarce regarding outcomes and timing of return to sports (RTS) in these patients. Purpose: (1) To report minimum 2-year patient-reported outcome (PRO) scores and RTS characteristics for high-level athletes undergoing primary labral reconstruction for irreparable labral tears and (2) to compare clinical results with a matched control group of athletes undergoing labral repair. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed for high school, college, and professional athletes who underwent a primary arthroscopic labral reconstruction between January 2010 and June 2018. Minimum 2-year PROs were compared for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and Hip Outcome Score–Sport Specific Subscale (HOS-SSS), as well as the visual analog scale (VAS) pain score, patient satisfaction, and RTS. The percentages of patients achieving the Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID) for the mHHS (PASS, >74 points; MCID, >8 points) and HOS-SSS (PASS, >75 points; MCID, >6 points) were also recorded. These patients were propensity score matched in a 1:3 ratio to other high-level athletes undergoing labral repair. Results: A total of 17 high-level athletes with primary arthroscopic labral reconstruction were included with a median follow-up time of 37.1 months (95% CI, 37.2-60.3 months). They demonstrated significant improvement from preoperatively to the latest follow-up for mHHS, NAHS, HOS-SSS, and VAS for pain ( P < .05). Further, patients achieved PASS/MCID for mHHS at high rates (PASS, 84.2%; MCID, 68.4%). Athletes were able to return to sport-specific training at a median of 3.33 months (95% CI, 3.07-4.71 months) and RTS at a median of 6.2 months (95% CI, 5.08-11.98 months). Fourteen (82.4%) of reconstructions and 29 (82.8%) of repairs either returned to sport or decided not to do so for reasons unrelated to the hip. PROs, RTS rate, and PASS/MCID rates were similar between the labral reconstruction group and a control labral repair group ( P > .05). Conclusion: Primary arthroscopic labral reconstruction for irreparable labral tears was associated with significant improvement in PROs and high rates of RTS in high-level athletes. These results were comparable with those of a control group of athletes undergoing labral repair.

scholarly journals ‘Mini-Max’ knotless acetabular labrum repair: repair construct rationale and allocation in a consecutive case series with minimum 1-year clinical outcomes

2021 ◽  
Author(s):  
John J Christoforetti ◽  
Gabriella Bucci ◽  
Beth Nickel ◽  
Steven B Singleton ◽  
Ryan P McGovern
Keyword(s):  
Clinical Outcomes ◽  
Descriptive Analysis ◽  
Case Series ◽  
Labral Repair ◽  
Suture Anchors ◽  
Acetabular Labrum ◽  
Retrospective Case ◽  
Labral Tears ◽  
Patient Reported

ABSTRACT To describe the ‘mini-Max’ approach to labrum repair using non-absorbable 2.4-mm knotless suture anchors and report objective clinical outcomes with a large single-surgeon cohort. Level 3 retrospective case series. A retrospective review was conducted to report the use and allocation of non-absorbable 2.4-mm knotless suture anchors during ‘mini-Max’ labral repair from 2015 to 2018. Descriptive analysis of the labral damage severity, size and number of anchors used to arthroscopically repair the acetabular labrum was performed. Paired-samples t-tests were performed to evaluate whether preoperative and 1-year follow-up patient-reported outcomes (PROs) were statistically significant. An analysis of variance was performed comparing PROs with categorized number of labral anchors. A total of 390 patients were queried in this study, with 330 (85%) diagnosed intraoperatively with acetabular labral tears. A total of 245 patients (137 females and 108 males) with a mean age of 30.1 ± 11.6 years (mean ± SD) at the time of surgery underwent ‘mini-Max’ labral refixation. Of the 245 labral tears, 88 (35.9%) were graded as mild, 113 (46.1%) as moderate and 44 (18.0%) as severe. Labral repairs required an average of 2.1 ± 0.67 anchors across all patients included. Forty-one repairs (16.7%) required one anchor, 139 (56.7%) required two anchors, 63 (25.7%) required three anchors and 2 (0.8%) required four anchors. Significant improvements were reported for all PROs (P ≤ .001) at a minimum of 1-year follow-up. Arthroscopic ‘mini-Max’ labral repair using non-absorbable knotless suture anchors is a safe and effective technique for improving the lives of patients suffering from symptomatic acetabular labrum tears.

Clinical Outcomes of Physiotherapy for Patients with Acetabular Labral Tears: An Analysis According to Severity of Injury

2020 ◽  
Author(s):  
Makoto Kawai ◽  
Kenji Tateda ◽  
Yuma Ikeda ◽  
Ryosuke Motomura ◽  
Ima Kosukegawa ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Labral Tear ◽  
Stage Iii ◽  
Labral Repair ◽  
Short Term ◽  
Post Intervention ◽  
Term Outcome ◽  
Labral Tears ◽  
Acetabular Labral Tear ◽  
Severity Of Injury

Abstract Background: Arthroscopic labral repair is an effective treatment for femoroacetabular impingement (FAI) and acetabular labral injury. However, the effectiveness of physiotherapy treatment is controversial. Previous studies that analyzed the outcome of physiotherapy for patients with FAI or acetabular labral tears did not consider damaged tissues or the severity of the acetabular labral tear. This study aimed to evaluate (1) the short-term outcome of physiotherapy in patients with acetabular labral tears confirmed by magnetic resonance imaging (MRI) and (2) the effectiveness of physiotherapy according to the severity of the labral tear.Methods: Thirty-five patients who underwent physiotherapy for symptomatic acetabular labral tears from August 2013 to July 2018 were enrolled. We evaluated the severity of the acetabular labral tears, which were classified based on the Czerny classification system using 3-T MRI. Clinical findings of microinstability and extra-articular pathologies of the hip joint were also examined. Outcome scores were evaluated using the International Hip Outcome Tool 12 (iHOT12) at pre- and post-intervention.Results: The mean iHOT12 score significantly improved from 44.0 to 73.5 in 4.7 months. The post-intervention iHOT12 scores were significantly higher than the pre-intervention scores at stages I (pre 51.0, post 74.4; P=0.004) and II (pre 44.8, post 81.2; P<0.001). However, there were no significant differences between the pre-intervention and post-intervention iHOT12 scores at stage III (pre 36.6, post 60.8; P=0.061). Furthermore, 7 patients (20.0%) had positive microinstability tests, and 22 (62.9%) had findings of extra-articular pathologies. Of 35 patients, 8 (22.9%) underwent surgical treatment after failure of conservative management, of whom 4 had Czerny stage III.Conclusions: Physiotherapy significantly improved the iHOT12 score of patients with acetabular labral tears in the short-term period. In patients with severe acetabular labral tear, improvement of clinical score by physiotherapy may be poor. Identifying the severity of acetabular labral tears can be useful in determining treatment strategies.

scholarly journals Use of an Elastomeric Knee Brace in Patellofemoral Pain Syndrome: Short-Term Results

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 085-089 ◽  
Author(s):  
Francesco Uboldi ◽  
Paolo Ferrua ◽  
Daniele Tradati ◽  
Pietro Zedde ◽  
Jim Richards ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Return To Sport ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Rehabilitation Program ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Group A ◽  
Group B

Purpose This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Methods Two groups of 30 patients with PFPS were prospectively and randomly allocated to a rehabilitation protocol, with (group A) or without (group B) the use of a specific brace. All the patients were assessed at 3, 6, and 12 months using the disease-specific Kujala scale and a visual analog scale (VAS) for pain; time to return to sport and patient satisfaction with the brace were also recorded. Results Kujala scale's values showed constant and progressive improvement. The mean score at 6 months was 79.8 ± 6.8 points in group A and 76.8 ± 8.6 in group B, rising at 12 months to 80.9 ± 7.5 in group A and 78.4 ± 8.3 in group B. VAS scores significantly differed (p < 0.05) between the two groups at both 6 and 12 months; the score recorded at 12 months was 0.9 ± 1.3 in the brace-treated group and 1.8 ± 1.6 in the controls. The patients who used a brace showed a quicker return to sports and 75% of the patients in this group were satisfied. Conclusion All the scores improved progressively in both groups. The most significant improvement concerned pain, showing that the brace used in this study may allow a better subjective outcome and a quicker return to sport. Level of Evidence Level II, prospective randomized controlled trial.

scholarly journals Clinical outcomes of arthroscopic repair of acetabular labral tears

2018 ◽  
Vol 4 (1) ◽  
pp. e000328 ◽  
Author(s):  
Carlos César Vassalo ◽  
Antônio Augusto Guimarães Barros ◽  
Lincoln Paiva Costa ◽  
Euler de Carvalho Guedes ◽  
Marco Antônio Percope de Andrade
Keyword(s):  
Clinical Outcomes ◽  
Arthroscopic Repair ◽  
Final Evaluation ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Senior Surgeon ◽  
Labral Tears ◽  
Significant Difference ◽  
The Mean

PurposeTo evaluate the primary clinical outcomes of arthroscopic labral repair.MethodsAll patients who underwent arthroscopic repair of the acetabular labrum performed by a senior surgeon between October 2010 and December 2013 were invited to participate in this prospective study. Patients included were those who had a preoperative diagnosis of labral tears, a lateral centre edge greater than 25° and a labral tear believed to be suturable during the intraoperative evaluation. Patients with Tönnis grade 2 or grade 3 hip osteoarthritis and those who had undergone a previous hip surgery were excluded. All patients were evaluated using the modified Harris Hip Score (mHHS) during the final appointment before surgery, 4 months after surgery and at the final evaluation. Interviews were conducted by the senior surgeon.ResultsEighty-four patients (90 hips) underwent arthroscopic repair. The mean age was 44.2 years and the mean follow-up period was 43.0 months (minimum of 25 months and maximum of 59 months). The mean mHHS was 80.4 preoperatively, 95.0 at 4 months postoperatively and 96.6 at final evaluation. A statistically significant difference existed among these scores (p<0.001).ConclusionArthroscopic labral repair was associated with a clinically significant improvement in mHHS after short-term (4 months) and medium-term (43 months) follow-up.Level of evidenceLevel IV, therapeutic case series.

scholarly journals Tegner level is predictive for successful return to sport 2 years after anterior cruciate ligament reconstruction

2020 ◽  
Author(s):  
Antonio Klasan ◽  
Sven Edward Putnis ◽  
Samuel Grasso ◽  
Vikram Kandhari ◽  
Takeshi Oshima ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Regression Analysis ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Rehabilitation Program ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Abstract Purpose For a successful return to sport (RTS) after an anterior cruciate ligament reconstruction (ACLR), patients are recommended to attend a comprehensive rehabilitation program, followed by an RTS assessment, that is a combination of tests. The purpose of this study was to predict a successful return to sport using the results of the RTS assessment and self-reported questionnaires at minimum 2 years after ACLR. Methods A total of 123 consecutive ACLR patients undertook an intensive rehabilitation program followed by a comprehensive RTS assessment that included an established combination of balance and strength tests, the ACL-return to sport after Injury scale (ACL-RSI) questionnaire and a KT1000 laximetry test. Preinjury and expected Tegner and Lysholm were collected at baseline, at RTS and prospectively collected at minimum 2-year follow-up. The patients were asked if they returned to their previous sport and at which level. All variables were included in a regression analysis predicting a successful return to previous sport, return to the same level of sport as well as the Tegner level at 2 years. Results Sixty-two patients (50%) returned to their previous sport by the 2-year follow-up, without a difference in preinjury Tegner between these two groups (n.s.). Expected preoperative Tegner was the only significant predictor of a successful return to previous sport (p = 0.042; OR 1.300, 95% CI 1.010–1.672). Out of the 62 patients returning to their previous sport, 38 (61%) reported to be on the same or higher level. The only predictive variable for returning to the same level was the higher preinjury Tegner level (p = 0.048; OR 1.522). Multivariate regression analysis of Tegner level at 2 years found younger age to be the only predictive value. From the RTS assessment tests, the ACL-RSI questionnaire and the posterolateral balance test were predictive variables for Tegner at 2-year follow-up, albeit in the univariate regression analysis. Conclusions Preoperative Tegner and expected Tegner level collected prior to an ACL reconstruction can aid in the objective prediction of patients’ return to sport after 2 years. High-level athletes are more likely to return to their previous sport and to the previous level. Younger patients achieve a higher Tegner level at 2 years. Level of evidence Level III study.

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